| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $136 | $157 | $177 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $57 | $73 | $88 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $70 | $91 | $113 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $97 | $97 | $97 |
| Group psychotherapy CPT 90853 • Mental Health | $25 | $38 | $52 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $1 | $1 | $1 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $5 | $64 | $123 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $12 | $12 | $12 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $87 | $105 | $123 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $70 | $211 | $351 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $407 | $407 | $408 |
| Electromyography (EMG) 1 extremity CPT 95860 • Neurology | $57 | $81 | $104 |
| Electromyography (EMG) 2 extremities CPT 95861 • Neurology | $76 | $113 | $150 |
| EMG needle each extremity complete CPT 95886 • Neurology | $19 | $54 | $90 |
| Nerve conduction study 1-2 nerves CPT 95907 • Neurology | $83 | $83 | $84 |
| Nerve conduction study 3-4 nerves CPT 95908 • Neurology | $62 | $83 | $104 |
| Nerve conduction study 5-6 nerves CPT 95909 • Neurology | $75 | $75 | $75 |
| Nerve conduction study 7-8 nerves CPT 95910 • Neurology | $99 | $131 | $164 |
| Nerve conduction study 13 or more nerves CPT 95913 • Neurology | $268 | $268 | $268 |
| Office visit new patient straightforward CPT 99202 • Office Visits | $51 | $51 | $52 |
| Office visit new patient low complexity CPT 99203 • Office Visits | $79 | $87 | $94 |
| Office visit new patient moderate complexity CPT 99204 • Office Visits | $12 | $12 | $12 |
| Office visit new patient high complexity CPT 99205 • Office Visits | $130 | $130 | $130 |
| Office visit established patient minimal CPT 99211 • Office Visits | $6 | $7 | $7 |
| Office visit established patient straightforward CPT 99212 • Office Visits | $20 | $30 | $40 |
| Office visit established patient low complexity CPT 99213 • Office Visits | $7 | $36 | $64 |
| Office visit established patient moderate complexity CPT 99214 • Office Visits | $12 | $52 | $92 |
| Office visit established patient high complexity CPT 99215 • Office Visits | $17 | $73 | $128 |
| Initial hospital care low complexity CPT 99221 • Office Visits | $39 | $49 | $59 |
| Initial hospital care moderate complexity CPT 99222 • Office Visits | $52 | $73 | $93 |
| Initial hospital care high complexity CPT 99223 • Office Visits | $15 | $70 | $125 |
| Subsequent hospital care low complexity CPT 99231 • Office Visits | $4 | $20 | $35 |
| Subsequent hospital care moderate complexity CPT 99232 • Office Visits | $6 | $31 | $57 |
| Subsequent hospital care high complexity CPT 99233 • Office Visits | $12 | $49 | $86 |
| Hospital discharge day management 30 minutes or less CPT 99238 • Office Visits | $44 | $51 | $58 |
| Hospital discharge day management more than 30 min CPT 99239 • Office Visits | $82 | $82 | $82 |
| Consultation office low complexity CPT 99243 • Office Visits | $80 | $80 | $80 |
| Consultation office high complexity CPT 99245 • Office Visits | $42 | $116 | $189 |
| Blepharoplasty upper eyelid CPT 15823 • Ophthalmology | $370 | $415 | $460 |
| Foreign body removal external eye corneal CPT 65210 • Ophthalmology | $18 | $27 | $36 |
| Corneal transplant endothelial CPT 65756 • Ophthalmology | $827 | $963 | $1,100 |
| Trabeculoplasty laser surgery CPT 65855 • Ophthalmology | $115 | $115 | $115 |
| Trabeculectomy glaucoma filtering surgery CPT 66170 • Ophthalmology | $1,019 | $1,058 | $1,097 |
| Endoscopic cyclophotocoagulation CPT 66711 • Ophthalmology | $76 | $273 | $470 |
| Iridotomy laser surgery CPT 66761 • Ophthalmology | $61 | $61 | $61 |
| Cataract surgery complex with intraocular lens CPT 66982 • Ophthalmology | $561 | $561 | $561 |
| Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology | $508 | $508 | $508 |
| Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology | $9 | $9 | $9 |
| Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology | $554 | $554 | $554 |
| Retinal photocoagulation treatment CPT 67210 • Ophthalmology | $481 | $481 | $481 |